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General NPI Number Information
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NPI Number | 1548719248
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Entity Type | Organization
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Legal Business Name | EMPOWER PHYSICAL THERAPY
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Dates
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Enumeration Date | 09/23/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 8 DUSKO DR
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City | PARLIN
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State | NJ
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Zip | 08859-2023
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Country | US
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Telephone | 732-925-2025
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Fax |
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Provider Business Mailing Address
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Address Line | 8 DUSKO DRIVE
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City | PARLIN
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State | NJ
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Zip | 08859
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FARRIS FAKHOURY
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Credential |
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Telephone | 732-925-2025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA01449800
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License Number State | NJ
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